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经颅直流电刺激与神经精神疾病中的认知:证据的系统综述及未来方向

Transcranial Direct Current Stimulation and Cognition in Neuropsychiatric Disorders: Systematic Review of the Evidence and Future Directions.

作者信息

Ciullo Valentina, Spalletta Gianfranco, Caltagirone Carlo, Banaj Nerisa, Vecchio Daniela, Piras Fabrizio, Piras Federica

机构信息

Neuropsychiatry Laboratory, Department of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Rome, Italy.

Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA.

出版信息

Neuroscientist. 2021 Jun;27(3):285-309. doi: 10.1177/1073858420936167. Epub 2020 Jul 9.

Abstract

Transcranial direct current stimulation (tDCS) has been implemented in neuropsychiatric disorders characterized by cognitive impairment. However, methodological heterogeneity challenges conclusive remarks. Through a critical analysis of previous conflicting findings and in the light of current neurobiological models of pathophysiology, we qualitatively assessed the effects of tDCS in neuropsychiatric disorders that share neurobiological underpinnings, as to evaluate whether stimulation can improve cognitive deficits in patients' cohorts. We performed a systematic review of tDCS studies targeting cognitive functions in mental disorders and pathological cognitive aging. Data from 41 studies, comprising patients with diagnosis of mood disorders, schizophrenia-spectrum disorders, Alzheimer's disease (AD), and mild cognitive impairment (MCI), were included. Results indicate that tDCS has the capacity to enhance processing speed, working memory, and executive functions in patients with mood and schizophrenia-spectrum disorders. The evidence of a positive effect on general cognitive functioning and memory is either inconclusive in AD, or weak in MCI. Future directions are discussed for developing standardized stimulation protocols and for translating the technique therapeutic potential into effective clinical practice.

摘要

经颅直流电刺激(tDCS)已应用于以认知障碍为特征的神经精神疾病。然而,方法学的异质性对得出结论性的观点构成了挑战。通过对先前相互矛盾的研究结果进行批判性分析,并结合当前病理生理学的神经生物学模型,我们定性评估了tDCS对具有神经生物学基础的神经精神疾病的影响,以评估刺激是否能改善患者群体的认知缺陷。我们对针对精神障碍和病理性认知老化中认知功能的tDCS研究进行了系统综述。纳入了41项研究的数据,这些研究的患者诊断包括情绪障碍、精神分裂症谱系障碍、阿尔茨海默病(AD)和轻度认知障碍(MCI)。结果表明,tDCS有能力提高情绪和精神分裂症谱系障碍患者的处理速度、工作记忆和执行功能。对AD患者的一般认知功能和记忆产生积极影响的证据尚无定论,而在MCI患者中则较为薄弱。讨论了未来开发标准化刺激方案以及将该技术的治疗潜力转化为有效临床实践的方向。

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